Douglas E Frederick, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

45623 Issued in KS

Practice address

1947 N Founders Cir
Wichita, KS 67206-3548

Phone

(316) 613-4640

Fax

(316) 689-9769

NPI assigned

Jun 16, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400457600000",
    "number": "1174528053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8035",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672080035",
            "telephone_number": "316-689-9135",
            "fax_number": "316-689-9667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1947 N FOUNDERS CIR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063548",
            "telephone_number": "316-613-4640",
            "fax_number": "316-689-9769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "DOUGLAS",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2014-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "45623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OK MEDICAID",
            "identifier": "20041080A",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200278930E",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "003719299",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nalini Fraser, PHARMD
• Erika Frazier, RN
• Mariah Leanne Frazier, DDS
• Rebecca Marie Frazier
• Charles Hugh Frederick III, PHARM.D.
• Heather Joy Frederick, PHARMD RPH
• Leslie Frederick, M.S. CCC-SLP
• Marguerite Eowyn Fredericksen
• Chassidi Frederickson
• Joshua Frederiksen, MD

• Nurse Practitioner in Wichita, KS
• Providers in Wichita, KS by specialty
• Nurse Practitioner in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.